Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft

Background A triangular fibrocartilage complex (TFCC) injury can produce distal radioulnar joint (DRUJ) instability. If the foveal attachment is avulsed, it translates distally. The footprint is separated from its origin and will become covered in synovitis, preventing healing. The authors describe a surgical technique for the treatment of instability of the DRUJ due to chronic foveal detachment of the TFCC. Technique The procedure utilizes a loop of autologous palmaris longus tendon graft passed through the ulnar aspect of the TFCC and through an osseous tunnel in the distal ulna to reconstruct the fovel attachment. Patients and Methods We report on nine patients with a mean age of 42. Median follow-up was 13 months. Results The median pain scores measured were reduced from 8 to 3 postoperatively, and all had a stable DRUJ. Conclusions This technique provides stability of the distal ulna to the radius and carpus, with potential for biologic healing through osseous integration. It is a robust, anatomically based reconstruction of the TFCC to the fovea that stabilizes the DRUJ and the ulnar-carpal sag.

Dem milner's treren : The millers tears ; folk song

Jacob Beimel

The Trail of No Tears: Traditional Masculinity Ideologies and The Cycle of Dismissing-Avoidant Attachment

Raising boys in accordance with traditional masculinity ideologies is creating a mental health crisis among men. Socialization in accordance with traditional male gender roles causes boys to develop dismissing-avoidant attachments with their primary caregivers. Approaching subsequent relationships with a dismissing-attachment style creates disconnection between men and male peers, female partners, and their children. Many researchers advocate clinical interventions that perpetuate men's traditional fears of intimacy, however attachment theory provides an alternative lens through which clinicians may approach therapy with men. By engaging men in therapeutic attachment relationships, clinicians can inspire implicit and explicit learning of new attachment patterns. This experience by nature challenges traditional definitions of masculinity, and men may develop more congruent, adaptive, and healthy definitions of masculinity.

Dragon Tears: Highlighting the Christian Salvation Message Through the Use of Allegorical Fantasy Fiction

The recent movie versions of the Chronicles of Narnia and the Lord of the Rings Trilogy have raised in the publishing world a public demand for good quality fantasy fiction that can be used as a teaching tool for spreading the Christian salvation message. Dragon Tears was written to fulfill this need, providing young adult readers with both an engaging fantasy story and at the same time, an allegorical format through which to receive the Christian salvation story. Dragon Tears draws its foundational material from two educational backgrounds in religion and creative writing.

Between tears and laughter.

Mode of access: Internet.

No time for tears,

Mode of access: Internet.

A queen of tears, Caroline Matilda, queen of Denmark and Norway and princess of Great Britain and Ireland.

"List of authorities": v. 2. p. 327-329.

Tears of contrition; or, Sketches of the life of John N. Maffitt: with religious and moral reflections. To which are appended several poetic effusions.

Microfilm. Ann Arbor, Mich., Xerox University Microfilms, 1972. 35 mm. (American Culture Series, reel 531.2)

Trail of Tears National Historic Trail : report (to accompany S. 1970).

"April 20, 2006."

No time for tears.

Mode of access: Internet.

Fighting, anger, frustration and tears: Matthew's story of hegemonic masculinity

This paper draws on Matthew's story to illustrate the conflicting discourses of being a boy and being a student. Matthew is 12 years old and in Grade Six, his final year at Banrock Primary ( a K- 6 Australian State School). School is far from a happy place for Matthew - his tearful accounts of his combative relationships with his peers and his teacher highlight his emotional distress. The paper's analytic focus draws attention to some of the ways Matthew's harmful storylines of hegemonic masculinity are made possible through, in particular, his teacher's gendered philosophies and her strategies of individualism and control. In this regard, Matthew's story provides insight into the potentially counterproductive realities of teacher practice in relation to addressing issues of masculinity within the school environment. Against this backdrop, the paper stresses the importance of teachers drawing on a sound research-based framework of gender knowledges that can illuminate how masculinities are constructed, regulated and, indeed, transformed through the power relations of everyday social practice, including teacher practice.

Albumin in tears

Albumin is not endogenous to the tear film and is present as a product of plasma leakage. It is used as a diagnostic marker of ocular insult and inflammation. Tear albumin is, however, poorly understood, with large variations in reported concentrations between studies. There is also no authoritative information on whether its presence in tears is responsive or part of an adaptive reaction.The presented research aimed to resolve the disparities in published tear albumin concentrations and investigate the role of albumin in the tear film. Collation and evaluation of the available literature identified collection method, stimulus, assay technique, and disease state as factors able to influence quoted tear albumin to different extents. Difference in sampling technique exhibited the largest variations in mean tear albumin concentrations. Review of the literature also highlighted that little systematic investigations of the daily cycle of tear albumin levels, and subject-to-subject-variation, had been carried out. In order to remedy this shortcoming, variations in tear albumin concentration were investigated in 13 subjects throughout the waking day. Results identified a time period where albumin levels are relatively stable (2-6 hours post-waking). This was designated a suitable baseline for the determinations of tear albumin concentrations and subject-to-subject comparisons. Significantly, a previously unrecognised progressive increase in albumin concentration during the latter part of the day was also identified in the population. This increase suggests that albumin may play a more active and dynamic role in the ocular environment than is commonly perceived. To facilitate the collection of additional tear albumin data, tear sampling and point-of-care analysis in contact lens clinics were investigated. Two instruments were evaluated and were found to be suitable for the analysis of tear albumin in commercial institutions. Collectively, the described research has provided new insight into tear albumin and a strong foundation for further studies.

Costs, quality of life and cost-effectiveness of open and arthroscopic repair for rotator cuff tears : economic evaluation alongside the UKUFF trial

FUNDING & ACKNOWLEDGEMENTS This project was funded by the NIHR Health Technology Assessment programme (project number 05/47/02) and is published in full in Health Technology Assessment; Vol. 19, No. 80. Further information available at: http://www.nets.nihr.ac.uk/projects/hta/054702 This paper presents independent research commissioned by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the HTA programme or the Department of Health. Due to the confidential nature of the trial data supporting this publication not all of the data can be made accessible to other researchers. Please contact the UKUFF study principal investigator Andrew Carr (andrew.carr@ndorms.ox.ac.uk) for more information. The authors wish to thank the UKUFF trial collaborators for their contribution in managing the conduct of the trial, and for their comments on the interim economic results: Marion Campbell and Hannah Bruhn (Centre for Healthcare Randomised Trials, HSRU, University of Aberdeen), Jonathan Rees MD and David Beard (NDORMS, University of Oxford; NIHR Oxford Biomedical Research Centre), Jane Moser (NDORMS, University of Oxford), Raymond Fitzpatrick and Jill Dawson (NDPH, University of Oxford).

Diadenosine polyphosphates in the tears of aniridia patients

Purpose To quantify diadenosine polyphosphate levels in tears of congenital aniridia patients to estimate the ocular surface changes associated with congenital aniridia compared to normal individuals. Methods Fifteen patients diagnosed with congenital aniridia and a control group of forty volunteers were studied. Tears were collected to quantify the levels of diadenosine polyphosphates Ap4A and Ap5A by high-performance liquid chromatography (H.P.L.C). Break-up time (BUT), corneal staining, McMonnies questionnaire and the Schirmer I test were applied to both groups. Results Dinucleotides in congenital aniridia patients were higher than in control subjects. For the congenital aniridia group, under 15 years old, the values were 0.77 ± 0.01 μm and 0.17 ± 0.02 μm for Ap4A and Ap5A, respectively. The group aged from 15 to 40 years old provided concentrations of 4.37 ± 0.97 μm and 0.46 ± 0.05 μm for Ap4A and Ap5A, the group over 40 gave concentrations of 11.17 ± 5.53 μm and 0.68 ± 0.17 μm for Ap4A and Ap5A. Dinucleotide concentrations increased with age, being statistically significant different among the three age groups (p < 0.05). Congenital aniridia patients showed a normal tear secretion and no dry eye McMonnies scores, except for the group over 40 years old. BUT values decreased and corneal staining increased with age and correlated with the levels of diadenosine polyphosphates (p < 0.05). Conclusions The levels of dinucleotides in tears increase in aniridia patients compared with healthy subjects, and they seem to be related with the progression of corneal disorders in aniridia patients, both of which increase with ageing.